Creative therapies in rehabilitation: What are creative therapies?

Illustration by Su Suh for rehabINK

PROFILE

By Alexandra Thompson & Cori Snow


Over the past decade, researchers have started to investigate the relationship between engagement in creative activities and well-being. Creative therapies are clinical interventions that combine arts modalities, creative processes, and psychosocial principles to foster health. Creative therapies can be divided into four categories: a) visual arts therapy; b) music engagement; c) movement-based creative expression; and d) expressive writing (1,2). The collection of reviews done on this topic generally conclude that for a variety of illnesses and diagnoses, creative therapies have positive effects on health (2,3).

Who Uses Creative Therapies?

While creative therapies are most commonly associated with the field of art therapy, another discipline that has demonstrated its great potential is occupational therapy (1). Occupational therapists (OTs) are regulated health professionals who help people engage in meaningful occupations (i.e., self-care, productivity, and leisure activities) in the face of disability, illness, and/or health challenges. Occupational therapists address health from a holistic perspective as they consider the fit between the person, their environment, and the occupation. This holistic perspective positions OTs well to provide activity-based therapies, including those centred around the arts.

The Creative Works Studio: A Practice-Based Example of Creative Therapies in Rehabilitation

The Creative Works Studio (CWS) is an arts-based community program that offers creative therapies to help individuals living with severe and persistent mental illness and/or addictions in their rehabilitation. The CWS was founded in 1995 by Isabel Fryszberg, an OT and artist by background, and is run in partnership with Good Shepherd Non-Profit Homes Inc. and St. Michael’s Hospital. According to Bernadette Wycks, the current managing lead of the studio, the CWS offers a variety of creative activities, including painting, drawing, photography, collage, ceramics, beadwork, music, movement, and writing.

04_creativetherapies_brightlife-alleethompson
Artwork by Creative Works Studio member Sarah Michelle Mayers

Objectives of the Program

The scope of occupational therapy complements the main objectives of the CWS, which are to (a) create a supportive, healing environment; (b) reduce stress and symptoms, and increase wellness and self-care through art and creative expression; (c) facilitate productivity and increase economic opportunity for members; and (d) build members’ level of capacity and mastery through member identified goals (4).

Interviews with Fryszberg, Wycks, and Dr. Bonnie Kirsh, a professor in the Department of Occupational Science and Occupational Therapy at the University of Toronto, revealed an important person factor which influences the success of creative therapy―the potential for an identity shift from patient to artist.

04_creativetherapies_photo3
Artwork by Creative Works Studio member Courtney Marshall

Fryszberg explained that she intentionally designed the physical environment to resemble an art studio and not a hospital room, to reinforce the shift in identity towards that of an artist.

To achieve this environment factor, Fryszberg located the studio in a building separate from the hospital and decorated the space with bright colours and comfortable furniture.

An occupation factor also related to the patient-artist identity shift is that members of the CWS are encouraged to sell their art, thus shifting the nature of the creative activity from leisure to productivity. To this day, the studio continues to encourage members to find meaning in their creative activities.

“With occupational therapy, it’s the doing of something that precipitates the healing…that has been the foundation of everything here [at the CWS].”

– Bernadette Wycks

Recent Changes to the Program

Despite the benefits of occupational therapy in rehabilitation, funding cuts have resulted in the loss of the facilitating OT role at the CWS. Current staff have backgrounds in art and education, but none are regulated health professionals. During the early days of the CWS, Fryszberg was able to incorporate occupational therapy interventions, such as individual goal setting and counselling, into creative activities. Fryszberg explained that these counselling sessions were crucial to helping individuals engage in creative activities in a meaningful way for their unique functional recovery. Although CWS members continue to benefit from the current program, the holistic OT perspective is an important lens that is missing.

04_creativetherapies_photo4
Artwork by Creative Works Studio member Nessa Neeli

A Call to Action

As Fryszberg shared in her interview, given how current funding opportunities in Canada favour evidence-based practice, it is important to have research that clearly supports the added value of professionals like OTs. Hence, to advocate for the funding of an OT role at the CWS, research that evaluates the value of OTs in arts-based community programs is needed.

04_creativetherapies_photo5
Artwork by Creative Works Studio member Leon McCurdy

Exploratory, qualitative research has been done on the CWS by Dam, Fryszberg, and Kirsh. They recruited CWS members as participants and explored their experience and the impact of the CWS at a time when there was direct OT involvement. CWS members reported improved self-awareness, self-esteem, flexibility, focus, and motivation. The CWS was also found to promote social connection and to reduce feelings of isolation. Importantly, CWS provided structure, purpose, and hope to their lives. Furthermore, membership in the CWS was associated with decreased anxiety, depression, and delusions (4).

This work by Dam, Fryszberg, and Kirsh highlights the psychosocial benefits of participating in an arts-based program founded on OT principles. However, there is limited research to demonstrate the clinical and cost-effectiveness of having direct OT involvement. This gap suggests that follow-up research is needed on the CWS and similar programs to further understand and quantify the impact of OT involvement in creative therapies.

04_creativetherapies_photo2
Artwork by Creative Works Studio member Courtney Marshall

In conclusion, a growing body of research suggests that participating in creative therapies positively impacts psychosocial health and well-being. There are a variety of approaches to creative therapies, both within the specific art form (e.g., visual arts, music, movement-based expression, and expressive writing) and across the backgrounds of the professionals who organize the programs (e.g., art therapists, OTs).

The CWS is a practice-based example of creative therapies in rehabilitation. Due to recent funding cuts, the CWS has lost direct OT involvement. Although it continues to follow the foundational tenets of occupational therapy, eliminating the OT role has resulted in the absence of individual goal setting and counselling. To advocate for the inclusion of OTs in programs like the CWS, more research is needed on the clinical and cost-effectiveness of creative therapies within occupational therapy practice.

04_creativetherapies_photo6
Artwork by Creative Works Studio member Michelle

Acknowledgment

Featured illustration by Daniela Casas for rehabINK.

To refer to this article, it can be cited as:

Thompson A, Snow C. Creative therapies in rehabilitation: What are creative therapies? rehabINK. 2019;6. Available from: https://rehabinkmag.com


References

  1.   Atkinson K, Wells C. Creative therapies: a psychodynamic approach within occupational therapy. Cheltenham: Nelson Thornes; 2000.
  2.   Stuckey HL, Nobel J. The connection between art, healing, and public health: a review of the current literature. American Journal of Public Health. 2010;100(2):254-263.
  3.   Jensen A, Bonde LO. The use of arts interventions for mental health and wellbeing in health settings. Perspectives in Public Health. 2018;138(4):209-214.
  4.   Dam A, Fryszberg I, Kirsh B. Understanding the experience and impact of a community art studio initiative for adults with serious mental illness through narrative explorations. International Journal of the Arts in Society. 2008;3(2):53-64.